Impacto na incidência de infecção relacionada a cateter vascular central após medidas de educação na unidade de terapia intensiva do Hospital Universitário João de Barros Barreto

Central venous catheters are commonly employed in the management of critically ill patients in intensive care units (ICU). Primary bloodstream infections resulting from central venous catheterization (CVC-BSI) are a common cause of excess morbidity, mortality, and medicalcare costs associated in the ICU setting. Many strategies have been used to decrease the risk of CVC-BSI and educational initiatives aimed at improving CVC insertion and care has been demonstrated successful results. The purpose of the study was to determine the impact of an educational program targeted to specific points observed during CVC care practices on decreasing CVC-BSI rates in ICU setting. This was a preintervention and postintervention study. Barros Barreto Hospital is a 260-bed university urban teaching hospital located in Belém city, Pará, Brazil and its ICU is a 10-bed surgical-medical unit. In this ICU, reported CVC-BSI from January 2003 to December 2005 was 11.8 episodes of CVC-BSI per 1000 CVC-days. Between January 2006 and July 2007 this study was carried in this setting. An educational program based on CDC Guidelines for Prevention of Intravascular Catheter- Related Infection directed to nurses and physicians was developed by a multidisciplinary task force to highlight correct practices for CVC care. Posters concerning CVC-BSI pathogenesis and prevention, tips about importance of handwashing were available in the unit. BSI-CVC rates were monitored in the following 12-months period after educational intervention. Twenty episodes of catheter-associated bloodstream infections (11.8 per 1,000 catheter-days) occurred in the 36 months before the introduction of the education program. Following implementation of the intervention, the rate of catheter-associated bloodstream infection decreased to four episodes in 1667 catheter-days (2.4 per 1,000 catheter-days), a decrease of 78%. Behavior changes such as adherence to hand hygiene before manipulating CVC and CVC dressing was dramatically enhanced after the educational intervention ...